5 Myths about Inducing Labor

Lynn Erdman is CEO of the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN), the foremost nursing authority that advances the health care of women and newborns through advocacy, research and the creation of high quality, evidence-based standards of care. AWHONN represents the interests of 350,000 registered nurses working in women’s health, obstetric, and neonatal nursing in the U.S.
Scheduling a baby’s birth by inducing labor with artificial hormones—rather than waiting for labor to start on its own—is now accepted as common practice. In fact, nearly 25% of U.S. births are now induced—a number that has more than doubled since 1990. Some of these inductions are needed, but too often are performed for the convenience of busy families or obstetric providers.
What gets lost during the increasing incidence of induction is the fact that outside of a medical need, inducing labor can result in serious immediate and long-term medical issues for a mother and her baby. Researchers have demonstrated the potentially disastrous health consequences that can occur for women and infants with non-medically indicated inductions. Evidence shows that when a mother and baby are healthy and well in pregnancy, the mother should be encouraged and supported to wait for labor to start naturally—to let baby pick his or her own birthday.Here are five myths about labor induction:

1. Labor inductions are the safest, most convenient way for women to begin the birthing process.

Many people don’t realize that undergoing labor induction for any reason is associated with immediate and long-term health risks. Induced labor can lead to excessive postpartum bleeding (or hemorrhage), which in turn, increases the risk for blood transfusion, longer hospital stays, hysterectomy, more hospital re-admissions and, in the worst cases, death. Induction also increases a woman’s risk of cesarean birth, which also increases the risk for infection, problems with the placenta implanting normally in future pregnancies, and potentially life-long pain from abdominal adhesions.
AWHONN recommends against inducing labor at any time during pregnancy unless it is medically necessary. The medication used to induce labor is a manufactured hormone and a type of drug that bears a heightened risk for causing serious patient harm when used in error. With the increasing incidence of labor induction and its resulting complications, it’s more apparent than ever that we must improve our understanding of the health consequences of administering artificial hormones, especially to vulnerable populations like pregnant women and infants. The short- and long-term health risks are just too serious to undergo labor induction outside of a medical need.

2. Inducing labor does not pose any risks for a baby.

Babies face their own set of risks, including increased fetal stress and respiratory illness, through labor induction, especially before 40 weeks. These issues can force a baby to be separated from his or her mother, interrupt mother/baby bonding, and result in less or no breastfeeding, which in turn increases a baby’s lifetime risks for childhood obesity and chronic illness. Worst of all, complications can mean an infant needs to be admitted to a neonatal intensive care unit, have a longer hospital stay, face more hospital re-admissions, and be separated for longer periods of time from his or her mother.

3. There are no health benefits for letting labor start naturally on its own.

There are significant reasons why it’s healthier for moms and babies to complete pregnancy by waiting for labor to start on its own. Naturally occurring hormones that prepare a woman and her fetus for labor and birth typically make labor faster, easier and with less stress on the baby than an induced labor. Spontaneous labor also triggers a cascade of hormones during labor and birth that:
• provide natural pain relief, calming a woman during labor;
• help the placenta detach from the uterus;
• increase mother-baby attachment after birth;
• warm the mother’s skin at birth, which helps baby warm and hold his own body temperature;
• enhance breastfeeding;
• clear fetal lung fluid; and
• ensure that the transfer of maternal antibodies to the fetus, which makes the newborn less vulnerable to infections has occurred prior to birth.
Additionally, researchers continue to show that a baby’s healthy development and growth benefits from a full 40 weeks of gestation. A woman reaches her estimated due date when she completes 40 weeks of pregnancy. Research shows that women having their first babies, on average, will begin labor four to eight days past their due dates and women having their second or more babies will begin labor two to three days beyond their due date. Learn more about the benefits of spontaneous labor at www.GoTheFull40.com.

4. Elective augmentation to speed labor is safe.

If labor is progressing slowly, some health care practitioners augment labor (or stimulate contractions) with the same drug used in labor inductions. While research on the risks of elective labor augmentation is limited, many of the risks associated with induction may apply because the same medication is used.
With these concerns in mind, AWHONN supports policies that limit non-medically indicated augmentation of labor and supports spontaneous labor when mother and fetus are healthy. Increasing funding for research and education about augmented labor would help improve understanding of safe labor and birthing practices.

5. Women in the United States do not die of pregnancy-related causes.

Unfortunately, the number of women dying during pregnancy and childbirth continues to increase in the U.S. Two to three women die every day from complications of labor and delivery, and evidence shows about half of these deaths could be prevented. Our nation has higher death rates among birthing women than at least 46 other countries, including South Korea, and Turkey. In fact, the United States is one of the only countries where maternal deaths and injuries have increased in the last decade.
More than 50,000 women each year in the U.S.—that’s one every 10 minutes—nearly dies from a severe complication related to pregnancy or childbirth. Severe bleeding after birth or postpartum hemorrhage (one of the risks of labor induction) is a leading cause of preventable maternal death and injury. Since investigators have demonstrated that using pharmacologic or mechanical methods to induce labor increases risks for health complications for mother and baby, AWHONN strongly recommends that women should agree to receive medications to induce labor only when there is a medical reason.

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LOVE your blog! This is so true…way to many interventions in L&D because docs are in a hurry. My biggest pet peeve is breaking water for no reason (and also without warning!). Also, I wonder if studies will one day show that the PP pitocin for moms and vitamin K shots for babies are unnecessary? We seem to be finding that Mother Nature does it better than we do…

Depending on the group practices of the Docs, it seems there are docs who prefer high interventions and the occasional doc who is willing to let nature take it’s course. Knowing the risks of pitocin inductions, it only makes sense to give the pp pit. The moms are often too tired and crowded w visitors to try to get the baby to nurse, giving her the natural stimulus for the uterine contractions. I was always a breastfeeding “natzi”, promoting the immediate initiation of breastfeeding. Many hospitals have waiting lists of pts waiting for a bed to deliver in. All the… Read more »

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4 years ago

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Poppy

I worked for a brief time on our L&D unit. All the nurses believed these myths. Natural labor birth plans and people who chose home or birth center births were scoffed at and ridiculed. I lasted 6 months and then couldn’t stand it anymore. Thank you for your post.

love this article. I am 44 years old and pregnant. when I went in for my last prenatal visit with my Dr. she says, “we will induce you on 40 weeks plus 1 day” if you don’t go into labor on your own. I was shocked. I said, “no, I don’t want to be induced” She proceeded to tell me that it would be medically necessary since my AMA and risks to the baby. I don’t feel comfortable with that. But this induction craze has become the norm and it drives me crazy. Out of all my friends, I am… Read more »

Howdy! This post couldn’t be written any better! Reading through this post reminds
me of my previous roommate! He constantly kept preaching about this.
I will send this post to him. Pretty sure he will have a great read.
Thanks for sharing!

My 2yr old’s delivery was a sorta kinda induced labor (She was my 2nd child, the oldest is 10). I arrived at 5am when I was 38w6d…I was in the VERY VERY early stages of labor (my husband freaked and insisted we go to the hospital asap lol). My OBGYN was the md on call and agreed to admit me. Partially bc I was over being pregnant and partially bc I had been having BP issues. Once admitted, my labor literally haulted. I was started on pitocin, small amounts, and increased gradually. Until late that evening when there was very… Read more »

[…] with more problems. Even though the information is out there, so many women are misinformed about inducing their labor. Every week I work, there seems to be a near-miss of someone who comes so close to having the […]

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4 years ago

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Lisa Lu

I have to say that I’m impressed with the 2 military hospitals I delivered at. I was a 40 year old primip with a deployed husband, at the time of my first baby. I thought they’d would want to induce me. I almost hoped they would, so I could “schedule” my mom to come help me. Well, they didn’t induce me. I had a friend fly in 3 days before my due date & my mom 2 days after hoping, I would have a support person for delivery. My daughter was 5 days late. Thankfully my mom was still in… Read more »

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4 years ago

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Anonymous

I love this but induction in itself is not associated with pph, counterintuitive I know but the evidence does not show a correlation. However it is associated with a higher risk of cesarean when the woman’s cervix is unfavorable which leads to a whole other set of issues…

just wait for labor as long as health of mom and baby are not compromised and enjoy those last few weeks of being pregnant.

[…] with more problems. Even though the information is out there, so many women are misinformed about inducing their labor. Every week I work, there seems to be a near-miss of someone who comes so close to having the worst […]

[…] with more problems. Even though the information is out there, so many women are misinformed about inducing their labor. Every week I work, there seems to be a near-miss of someone who comes so close to having the worst […]

[…] with more problems. Even though the information is out there, so many women are misinformed about inducing their labor. Every week I work, there seems to be a near-miss of someone who comes so close to having the worst […]

[…] with more problems. Even though the information is out there, so many women are misinformed about inducing their labor. Every week I work, there seems to be a near-miss of someone who comes so close to having the worst […]

[…] with more problems. Even though the information is out there, so many women are misinformed about inducing their labor. Every week I work, there seems to be a near-miss of someone who comes so close to having the worst […]